How does Meniere's disease affect the body? - Meniere's Disease - Sharecare Meniere's Disease How does Meniere's disease affect the body? A Honor Society of Nursing (STTI) answered In the worst cases, Meniere's disease can be incapacitating. Vertigo and dizziness may be so bad that patients fall down while trying to walk. Patients may lose their hearing in the affected ear or ears. Short-term effects may include nausea and vomiting. Patients may become anxious or depressed. Helpful? This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs. Videos (6) Meniere's Disease Meniere's disease is a disorder of the inner ear that causes severe spells of vertigo, making you feel like you're spinning. You can also have hearing loss, ringing (tinnitus, pronounced either TINN-itus or tinn-UH-tus)) or a feeling of fullness in your ear. (It usually affects just one ear).

Doctors don't fully understand Meniere's Disease but suspect that its caused by a combination of how fluid drains (or does not drain) from your ear, allergies, viruses and genes. There is no known cure for Meniere's Disease, but vertigo is treatable. Meniere's Disease Q&As Meniere's Disease - National Library of Medicine - PubMed Health Surgery for Ménière's disease Ménière's disease is characterised by recurrent attacks of three major symptoms: vertigo (rotational dizziness), deafness and tinnitus (ringing of the ears), and/or aural fullness, all of which are discontinuous and variable in intensity. The symptoms of Ménière's disease are thought to be caused by excess pressure in the fluids of the inner ear which leads to sudden attacks of vertigo and hearing loss. A number of surgical procedures, of varying levels of invasiveness, have been developed to reduce the symptoms of Ménière's disease, but it is not clear whether or not these are effective. The surgical interventions can be categorised as two types: one type of surgical intervention aims to affect the natural history of the disease, with conservation of vestibular function.

The other type aims to relieve symptoms by abolishing vestibular function. Both types of surgical intervention are considered in this review. Despite an extensive search the review authors only found two randomised controlled trials studying surgical interventions for Ménière's disease. Both of these trials, involving a total of 59 patients, studied endolymphatic sac surgery; one comparing it to placebo surgery and the other to a different type of surgery. Neither trial detected a significant difference between the treatment and control group. Diuretics for the treatment of Ménière's disease or syndrome Diuretics (drugs which reduce fluid accumulation in the body) are commonly used in the management of the symptoms of vertigo, hearing loss, tinnitus or aural fullness in patients with Ménière's disease. 'Endolymphatic hydrops' is an increase in the pressure of the fluids in the chambers of the inner ear and is thought to be the underlying cause of Ménière's disease. Diuretics are believed to work by reducing the volume (and therefore also the pressure) of these fluids. The authors of this systematic review carried out an extensive search but could not identify any randomised controlled trials of sufficient quality to include in the review.

There is no good evidence about the effect of diuretics on the symptoms of Ménière's disease and further research is needed. Betahistine for Ménière's disease or syndrome Ménière's disease is a disorder of the inner ear which results in a spinning form of dizziness (vertigo), hearing loss and ringing in the ear (tinnitus), and can be disabling. It has no known cause. When it is secondary to a known inner ear disorder, it is called Ménière's syndrome. Both can be difficult to diagnose. The drug betahistine hydrochloride (Serc®, Betaserc®) has been used to reduce the frequency and severity of the attacks. While the drug is very acceptable to those who use it, the review of trials did not find enough evidence to show whether it is helpful. Further research is needed. Surgery for Ménière's disease Ménière's disease is characterised by recurrent attacks of three major symptoms: vertigo (rotational dizziness), deafness and tinnitus (ringing of the ears), and/or aural fullness, all of which are discontinuous and variable in intensity.

The symptoms of Ménière's disease are thought to be caused by excess pressure in the fluids of the inner ear which leads to sudden attacks of vertigo and hearing loss. A number of surgical procedures, of varying levels of invasiveness, have been developed to reduce the symptoms of Ménière's disease, but it is not clear whether or not these are effective. The surgical interventions can be categorised as two types: one type of surgical intervention aims to affect the natural history of the disease, with conservation of vestibular function. The other type aims to relieve symptoms by abolishing vestibular function. Both types of surgical intervention are considered in this review. Despite an extensive search the review authors only found two randomised controlled trials studying surgical interventions for Ménière's disease. Both of these trials, involving a total of 59 patients, studied endolymphatic sac surgery; one comparing it to placebo surgery and the other to a different type of surgery. Neither trial detected a significant difference between the treatment and control group.

Diuretics for the treatment of Ménière's disease or syndrome Diuretics (drugs which reduce fluid accumulation in the body) are commonly used in the management of the symptoms of vertigo, hearing loss, tinnitus or aural fullness in patients with Ménière's disease. 'Endolymphatic hydrops' is an increase in the pressure of the fluids in the chambers of the inner ear and is thought to be the underlying cause of Ménière's disease. Diuretics are believed to work by reducing the volume (and therefore also the pressure) of these fluids. The authors of this systematic review carried out an extensive search but could not identify any randomised controlled trials of sufficient quality to include in the review. There is no good evidence about the effect of diuretics on the symptoms of Ménière's disease and further research is needed. Betahistine for Ménière's disease or syndrome Ménière's disease is a disorder of the inner ear which results in a spinning form of dizziness (vertigo), hearing loss and ringing in the ear (tinnitus), and can be disabling. It has no known cause. When it is secondary to a known inner ear disorder, it is called Ménière's syndrome.

Both can be difficult to diagnose. The drug betahistine hydrochloride (Serc®, Betaserc®) has been used to reduce the frequency and severity of the attacks. While the drug is very acceptable to those who use it, the review of trials did not find enough evidence to show whether it is helpful. Further research is needed. Meniere's Disease - Symptoms, Diagnosis, Treatment of Meniere's Disease - NY Times Health Information Ringing or roaring in the affected ear, called tinnitus Vertigo, or dizziness Severe vertigo is the symptom that causes the most problems. With vertigo, you feel as though you are spinning or moving, or that the world is spinning around you. Nausea, vomiting, and sweating often occur. Symptoms get worse with sudden movement. Often, you will need to lie down. You may feel dizzy and off-balance for anywhere from 20 minutes to 24 hours. Usually hearing loss is only in one ear, but it may affect both ears. Hearing tends to improve between attacks but gets worse over time. Low frequency hearing is lost first.

You also may have roaring or ringing in the ear (tinnitus), along with a sense of pressure in your ear Other symptoms include: Back to Top Treatment There is no known cure for Meniere's disease. However, lifestyle changes and some treatments can help relieve symptoms. Your doctor may suggest ways to reduce the amount of fluid in your body. This can often help control symptoms. Water pills (diuretics) may help relieve fluid pressure in the inner ear A low-salt diet may also help To help ease symptoms and stay safe: Avoid sudden movements, which may worsen symptoms. You may need help walking during attacks. Avoid bright lights, TV, and reading during attacks. They can make symptoms worse. Do not drive, operate heavy machinery, or climb until 1 week after your symptoms disappear. A sudden dizzy spell during these activities can be dangerous. Remain still and rest when you have symptoms. Gradually increase your activity after attacks. Symptoms of Meniere's disease can cause stress. Make healthy lifestyle choices to help you cope: Eat a well-balanced, healthy diet. Don't overeat. Exercise regularly, if possible.

Your health care provider may prescribe: Antinausea medicines to relieve nausea and vomiting Diazepam (Valium) or motion sickness medicines, such as meclizine (Antivert, Bonine, Dramamine) to relieve dizziness and vertigo You may need ear surgery if your symptoms are severe and do not respond to other treatments. Surgery to cut the vestibular nerve helps control vertigo. It does not damage hearing. Injecting steroids or an antibiotic called gentamicin directly into the middle ear can help control vertigo. Removing part of the inner ear (labyrinthectomy) helps treat vertigo. This causes complete hearing loss. Hearing aids may be needed for severe hearing loss. Back to Top References Crane BT, Schessel DA, Nedzelski J, Minor LB. Peripheral vestibular disorders. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery . 5th ed. Philadelphia, Pa: Mosby Elsevier;2010:chap 165. Phillips JS, Westerberg B. Intratympanic steroids for Ménière's disease or syndrome. Cochrane Database Syst Rev.

2011 Jul 6;(7):CD008514. Post RE, Dickerson LM. Dizziness: a diagnostic approach. Am Fam Physician . 2010;82:361-369. Pullens B, van Benthem PP. Intratympanic gentamicin for Ménière's disease or syndrome. Cochrane Database Syst Rev. 2011 Mar 16;(3):CD008234. More Information on This Topic News & Features Review Date: 9/25/2013 Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team. A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission ( URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M.

is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation ( A.D.A.M. Copyright The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited. Meniere's Disease | American Academy of Otolaryngology-Head and Neck Surgery News media interested in covering the latest from AAO-HNS/F can find information on embargoes, Annual Meeting press registration and more below. Please direct any interview requests or policy questions to our media and public relations staff at newsroom@entnet.org . What is Ménières disease?

Ménières disease describes a set of episodic symptoms including vertigo (attacks of a spinning sensation), hearing loss, tinnitus (a roaring, buzzing, or ringing sound in the ear), and a sensation of fullness in the affected ear. Episodes typically last from 20 minutes up to 4 hours. Hearing loss is often intermittent, occurring mainly at the time of the attacks of vertigo. Loud sounds may seem distorted and cause discomfort. Usually, the hearing loss involves mainly the lower pitches, but over time this often affects tones of all pitches. After months or years of the disease, hearing loss often becomes permanent. Tinnitus and fullness of the ear may come and go with changes in hearing, occur during or just before attacks, or be constant. Ménières disease is also called idiopathic endolymphatic hydrops and is one of the most common causes of dizziness originating in the inner ear. In most cases only one ear is involved, but both ears may be affected in about 15 percent of patients. Ménières disease typically starts between the ages of 20 and 50 years. Men and women are affected in equal numbers.

Because Ménières disease affects each person differently, your doctor will suggest strategies to help reduce your symptoms and will help you choose the treatment that is best for you. What are the causes? Although the cause is unknown, Menieres disease probably results from an abnormality in the volume of fluid in the inner ear. Too much fluid may accumulate either due to excess production or inadequate absorption. In some individuals, especially those with involvement of both ears, allergies or autoimmune disorders may play a role in producing Ménières disease. In some cases, other conditions may cause symptoms similar to those of Ménières disease. People with Ménières disease have a sick inner ear and are more sensitive to factors, such as fatigue and stress, that may influence the frequency of attacks. How is a diagnosis made? Your physician will take a history of the frequency, duration, severity, and character of your attacks, the duration of hearing loss or whether it has been changing, and whether you have had tinnitus or fullness in either or both ears. When the history has been completed, diagnostic tests will check your hearing and balance functions.

They may include: For hearing An audiometric examination (hearing test) typically indicates a sensory type of hearing loss in the affected ear. Speech discrimination (the patients ability to distinguish between words like sit and fit) is often diminished in the affected ear. For balance An ENG (electronystagmogram) may be performed to evaluate balance function. In a darkened room, eye movements are recorded as warm and cool water or air are gently introduced into each ear canal. Since the eyes and ears work in coordination through the nervous system, measurement of eye movements can be used to test the balance system. In about 50 percent of patients, the balance function is reduced in the affected ear. Rotational or balance platform testing, may also be performed to evaluate the balance system. Other tests Electrocochleography (ECoG) may indicate increased inner ear fluid pressure in some cases of Ménières disease. The auditory brain stem response (ABR), a computerized test of the hearing nerves and brain pathways, computed tomography (CT), or magnetic resonance imaging (MRI) may be needed to rule out a tumor occurring on the hearing and balance nerve.

Such tumors are rare, but they can cause symptoms similar to Ménières disease. What should I do during an attack of Ménières disease? Lie flat and still and focus on an unmoving object. Often people fall asleep while lying down and feel better when they awaken. How can I reduce the frequency of Ménières disease episodes? Avoid stress and excess salt ingestion, caffeine, smoking, and alcohol. Get regular sleep and eat properly. Remain physically active, but avoid excessive fatigue. Consult your otolaryngologist about other treatment options. How is Ménières disease treated? Although there is no cure for Ménières disease, the attacks of vertigo can be controlled in nearly all cases. Treatment may include: A low salt diet and a diuretic (water pill) Anti-vertigo medications Intratympanic injection with either gentamicin or dexamethasone. An air pressure pulse generator Surgery Your otolaryngologist will help you choose the treatment that is best for you, as each has advantages and drawbacks.

In many people, careful control of salt in the diet and the use of diuretics can control symptoms satisfactorily. Intratympanic injections involve injecting medication through the eardrum into the middle ear space where the ear bones reside. This treatment is done in the otolaryngologists office. The treatment includes either making a temporary opening in the eardrum or placing a tube in the eardrum. The drug may be administered once or several times. Medication injected may include gentamicin or corticosteroids. Gentamicin alleviates dizziness but also carries the possibility of increased hearing loss in the treated ear that may occur in some individuals. Corticosteroids do not cause worsening of hearing loss, but are less effective in alleviating the major dizzy spells. An air pressure pulse generatoris another option. This device is a mechanical pump that is applied to the persons ear canal for five minutes three times a day. A ventilating tube must be first inserted through the eardrum to allow the pressure produced by the air pressure pulse generator to be transmitted across the round window membrane and change the pressure in the inner ear. The success rate of this device has been variable. When is surgery recommended?

Surgery is needed in only a small minority of patients with Menieres disease. If vertigo attacks are not controlled by conservative measures and are disabling, one of the following surgical procedures might be recommended: Endolymphatic sac shunt or decompression procedure relieves attacks of vertigo in one-half to two-thirds of cases and the sensation of ear fullness is often improved. Control is often temporary. Endolymphatic sac surgery does not improve hearing, but only has a small risk of worsening it. Recovery time after this procedure is short compared to the other procedures. Selective vestibular neurectomy is a procedure in which the balance nerve is cut as it leaves the inner ear and goes to the brain. While vertigo attacks are permanently cured in a high percentage of cases, patients may continue to experience imbalance. Similar to endolymphatic sac procedures, hearing function is usually preserved. Labryrinthectomy and eighth nerve section are procedures in which the balance and hearing mechanism in the inner ear are destroyed on one side. This is considered when the patient with Ménières disease has poor hearing in the affected ear.

Labryrinthectomy and eighth nerve section result in the highest rates for control of vertigo attacks. Copyright © 2015 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly prohibited without prior written permission. Meniere's Syndrome - Ear Surgery Information Center Ear Surgery Information Center Home » Conditions » Meniere’s Syndrome Meniere’s Syndrome Vertigo Endolymlphatic Hydrops Meniere’s Disease is a very disturbing illness, presenting patients with hearing loss, pressure in the ear, tinnitus, severe imbalance and vertigo. Vertigo is the most dramatic and distressing symptom of Meniere’s; it is described as a sudden loss of normal balance or equilibrium. The room may suddenly begin to spin and rotate at high speed. Focusing is difficult, and if the vertigo continues, nausea and vomiting may occur. Vertigo is commonly caused by acute labyrinthitis (a viral inflammation of the inner ear), benign positional vertigo (a condition due to abnormally floating crystals in the inner ear that stimulate the nerve endings of the inner ear), delayed symptom of head injury, or result of cervical spine problems. Hearing loss typically fluctuates with hearing being worse some days than others.

The hearing loss in Meniere’s may lead to severe permanent hearing loss and deafness in the affected ear. People with Meniere’s Disease report that tinnitus may be variable and often worsen before an attack of vertigo. Tinnitus is often described as a motor-like whirring noise present only in the ear with the hearing loss. Pressure or a sense of fullness in the affected ear are also common. Meniere’s Disease rarely occurs in children. In most cases, it begins in both men and women in the thirties or early middle age. Also, Meniere’s is rarely noted for the first time in older people. Ear surgeons see many patients with dizziness. Very few of these patients actually have Meniere’s Disease. Symptoms Symptoms of Meniere’s Disease come in cycles. The patient suffers multiple episodes lasting several months at a time; then, it generally subsides. In some individuals, the symptoms seem to be more severe in spring, fall or when under extra emotional stress. The most unpredictable and frightening symptom of Meniere’s Disease is vertigo. The vertigo in Meniere’s Disease is thought to result from an accumulation of excessive fluid in the inner ear.

The fluid pressure stretches the membranes, that divide the compartments of the inner ear. As the membranes of the inner ear stretch, hearing diminishes and tinnitus worsens. When the membranes are severely stretched, the fluids of the inner ear may rupture them. This results in mixing of the fluids, one rich in sodium, the other rich in potassium. The mixture of these fluids is thought to bring on the vertigo. After the membranes rupture, they eventually heal, but some hearing is usually lost. Surprisingly, with salt restriction, careful dietary planning and a mild diuretic, the symptoms of Meniere’s Disease will often subside. In some cases, hearing can return to normal. Classic symptoms of Meniere’s aren’t always present. Sometimes, hearing loss will precede episodes of vertigo by several years. Tinnitus alone, without associated hearing loss or vertigo, is rarely caused by Meniere’s Disease. The only symptom in very early cases of Meniere’s may be a sense of fullness or pressure in one ear. Diagnosing Meniere’s Disease Other conditions can produce the same symptoms as Meniere’s Disease and, thus, have to be ruled out or excluded in order to develop an accurate diagnosis.

For instance, infections of the inner ear, including syphilis and Lyme’s Disease, may produce episodes of vertigo and hearing loss quite indistinguishable from Meniere’s; these symptoms usually occur in both ears. Tumors of the inner ear nerve (the eighth nerve), especially acoustic neuromas, can also produce similar symptoms. These tumors grow slowly and compress the nerve. Thus, the hearing loss doesn’t have periods of improvement. Also, the patient usually experiences imbalance rather than vertigo. Ten to 15 percent of cases resembling Meniere’s Disease may be the result of an immune disorder of the body, the system producing antibodies which attack the inner ear. Cholesteatomas (cystic growths) and other infections of the middle ear can also produce symptoms similar to Meniere’s. How We Diagnose Initial evaluation is based on a very careful history given to the ear surgeon, as well as an examination of the ears under the operating microscope to rule out obvious infections or visible growths. Then, a comprehensive hearing test (audiogram) is taken. A low frequency upsloping hearing loss of the neural type noted on the hearing test is typical of Meniere’s.

Additional testing is performed: electronystagmography, or balance test (ENG), electrocochleography (ECOG), brainstem evoked response audiometry (BSER), Magnetic Resonance Imaging (MRI) with a contrast dye called Gadolinium can rule out an acoustic neuroma or other brain tumor as a possible source of symptoms lab tests should include examination for inner ear immune related infections or conditions. Once testing is completed, the ear surgeon can evaluate the results, rule out extraneous conditions and confirm the diagnosis of Meniere’s Disease. Even after this extensive testing, the test results may not be conclusive. What the Tests Reveal ENG (electronystagmography) measures the nerve of balance. Over time, this nerve will lose function in Meniere’s Disease. Most patients with Meniere’s have a reduced response to stimulation with cold and warm water or air which is used in this test. Electrocholeography (ECOG) measures the excess fluid accumulation in the inner ear; in Meniere’s, this test will also confirm increased pressure due to excess fluids in the inner ear. The Brain Stem auditory evoked responses (BSER) will usually be normal despite the hearing loss, unless a central disorder is present.

What the Other Tests Show The MRI with Gadolinium specifically visualizes the eighth nerve (acoustic and balance nerve). Some older scanners can miss a small acoustic neuroma (tumor). Newer MRIs can actually visualize the structures of the inner ear including the cochlea and semicircular canals. This is most helpful. The eighth nerve can be clearly identified on MRI scan. A nerve that does not show enhancement (increase in brightness), when the dye is given, rules out an acoustic neuroma from the diagnosis. Laboratory tests are geared to identify other conditions that may be responsible for Meniere’s. Syphilis can involve the inner ear even twenty to thirty years after the original infection. Lyme Disease can also produce Meniere’s-like symptoms, and symptoms can surface months after the original infection. Individuals with certain auto immune disorders such as Lupus and severe rheumatoid arthritis, or who suffer from thyroid disorders such as Grave’s Disease and Hashimoto’s thyroiditis may be at higher risk for developing Meniere’s Disease. This sub-group with their potential auto immune cause for the Meniere’s can often be successfully treated with medications which slow the immune system’s responses: cortisone-containing medications such as Decadron or Prednisone.

Treatment When the diagnosis of Meniere’s Disease is eventually confirmed, treatment is directed at ending or markedly reducing the frequency and severity of attacks. Treatment includes modification of personal habits, diet, stress reduction and regular exercise — all extremely important in the overall treatment of Meniere’s Disease. Medications will be recommended; evaluation of all treatments must be carefully annotated. Dietary Dietary restriction of salt intake is primary. Most Americans consume over 10 grams of salt daily. Under normal conditions, the body requires 2 grams or less. The taste for salting food is an acquired one. Most individuals who restrict their salt intake become keenly aware of excess salt added to their food. Over time, salt restriction results in decreased fluid accumulation in the inner ear, reducing excess pressure on the nerve endings of balance and hearing. A daily diuretic, typically Hydrochlorthiazide (combined with Triamterene to retain potassium) help the body to further reduce fluid retention. Other Lifestyle Modifications Smoking must stop immediately. Smoking constricts and reduces blood flow to the tiny blood vessels which nourish the inner ear nerve endings.

Caffeine in coffee, tea and colas, as well as chocolate, must also be eliminated from the diet since caffeine excessively stimulates nerve endings. Reasonable exercise such as a daily brisk walk will stimulate circulation and help blood flow. A regular exercise program is also helpful. Vertigo Medications Use of medications such as Antivert (Meclizine) is usually of no benefit in true Meniere’s Disease, even if it helps in other balance disorders. However, Valium (Diazepam) and other Benzodiazepines have a direct effect on the nerve controlling balance and its central connections to the brain. When Valium is given at the onset of a vertigo attack, it can prevent the attack from continuing. (N.B. Valium and similar medications should not be taken daily, because they may be habit forming.) Eating: Pros & Cons Diets can include fresh meats, poultry, vegetables and fruits. Processed meats, canned products, monosodium glutamate, table salt and "Lite salt" should be avoided totally. Olives, pickled foods, chips and some cheeses are also very high in sodium and should be avoided. Flavor can be added by using natural herbs and other spices NOT mixed with salt.

Many individuals with Meniere’s follow a typical low salt diet, similar to those diets used to control high blood pressure. Dieticians, pamphlets, and diet books are sources of further information. Younger Patients Young patients may have symptoms which are more severe and resistant to treatment. When recurring bouts of vertigo begin to interfere with daily activities, surgical options are often discussed. Generally, surgery is not to be considered unless attacks of vertigo are severe and do not respond to treatment. Often, patients with Meniere’s have consulted a number of physicians who used the aforementioned treatments without success. Combining Cortisone-type medications with diuretics should be tried once again. Dyazide, combined with oral Decadron or Prednisone (cortisone) given over a period of 2 to 3 weeks will be helpful in gauging some form of medical response. If combined cortisone and diuretics plus diet are not effectice in improving clinical symptoms, then surgery is advised. Other Factors Meniere’s Disease is an episodic illness. Attacks come in cycles followed by symptom-free intervals. Studies measuring the results of treatment must be carried out over periods of years to be of scientific value.

Many treatments have been advocated at one time or another for Meniere’s, only to have them abandoned a few years later when studies proved them to be ineffective. Stress, emotional or physical, also seems to play a significant role in precipitating attacks. Some researchers have considered Meniere’s a psychosomatic illness (an illness that has a psycho- logical root). This is certainly not true in all cases of Meniere’s. There is no doubt that stress is often associated with attacks, but whether stress causes or is the result of the attack, is not clear. The vertigo attacks, when they occur, may be so frightening and unpleasant that apprehension exists constantly. The patient fears that an attack may interrupt life at any time. This can result in added fears and stresses, worsening the condition. It is important for the individual with Meniere’s to gain control again over the illness and be able to prevent attacks. This can often be achieved by medical therapy and rehabilitated lifestyle. In those cases where medical treatment and lifestyle modification are not successful (usually less than one-third), surgical treatment is often the curative solution. Meniere's disease Symptoms - Mayo Clinic By Mayo Clinic Staff Signs and symptoms of Meniere's disease include: Recurring episodes of vertigo.

You have a spinning sensation that starts and stops spontaneously. Episodes of vertigo occur without warning and usually last 20 minutes to several hours, but not more than 24 hours. Severe vertigo can cause nausea and vomiting. Hearing loss. Hearing loss in Meniere's disease may come and go, particularly early on. Eventually, most people have some permanent hearing loss. Ringing in the ear (tinnitus). Tinnitus is the perception of a ringing, buzzing, roaring, whistling or hissing sound in your ear. Feeling of fullness in the ear. People with Meniere's disease often feel pressure in the affected ears (aural fullness) or on the side of their heads. After an episode, signs and symptoms improve and might disappear entirely. Episodes can occur weeks to years apart. When to see a doctor See your doctor if you have signs or symptoms of Meniere's disease. Because any one of them can result from other illnesses, it's important to get an accurate diagnosis as soon as possible. Dinces EA, et al. Meniere disease. Accessed Oct. 3, 2015. Meniere's disease.

American Academy of Otolaryngology — Head and Neck Surgery. Accessed Oct. 3, 2015. AskMayoExpert. Recurrent vertigo. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015. Foster CA. Optimal management of Meniere's disease. Therapeutics and Clinical Risk Management. 2015;11:301. Meniere's disease. Vestibular Disorders Association. Accessed Oct. 3, 2015. Neff BA, et al. Auditory and vestibular symptoms and chronic subjective dizziness in patients with Meniere's disease, vestibular migraine, and Meniere's disease with concomitant vestibular migraine. Otology & Neurotology. 2012;33:1235. Bisdorff AR, et al. Overview of the international classification of vestibular disorders. Neurological Clinics. 2015;33:514. Furman JM, et al. Evaluation of the patient with vertigo. Accessed Oct. 5, 2015. Ferrarro JA, et al.

Electrocochleography in the evaluation of patients with Maniere's disease/endolymphatic hydrops. Journal of the American Academy of Audiology. 2006;17:45. Products and Services Ménière's Disease | NIDCD Ménière's Disease Where can I find additional information about Ménière’ disease? What is Ménière’s disease? Ménière’s disease is a disorder of the inner ear that causes severe dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a feeling of fullness or congestion in the ear. Ménière’s disease usually affects only one ear. Attacks of dizziness may come on suddenly or after a short period of tinnitus or muffled hearing. Some people will have single attacks of dizziness separated by long periods of time. Others may experience many attacks closer together over a number of days. Some people with Ménière’s disease have vertigo so extreme that they lose their balance and fall. These episodes are called “drop attacks.” Ménière’s disease can develop at any age, but it is more likely to happen to adults between 40 and 60 years of age.

The National Institute on Deafness and Other Communication Disorders (NIDCD) estimates that approximately 615,000 individuals in the United States are currently diagnosed with Ménière’s disease and that 45,500 cases are newly diagnosed each year. What causes the symptoms of Ménière’s disease? The labyrinth in relation to the ear The labyrinth is composed of the semicircular canals, the otolithic organs (i.e., utricle and saccule), and the cochlea. Inside their walls (bony labyrinth) are thin, pliable tubes and sacs (membranous labyrinth) filled with endolymph. Credit: NIH/NIDCD The symptoms of Ménière’s disease are caused by the buildup of fluid in the compartments of the inner ear, called the labyrinth. The labyrinth contains the organs of balance (the semicircular canals and otolithic organs) and of hearing (the cochlea). It has two sections: the bony labyrinth and the membranous labyrinth. The membranous labyrinth is filled with a fluid called endolymph that, in the balance organs, stimulates receptors as the body moves.

The receptors then send signals to the brain about the body’s position and movement. In the cochlea, fluid is compressed in response to sound vibrations, which stimulates sensory cells that send signals to the brain. In Ménière’s disease, the endolymph buildup in the labyrinth interferes with the normal balance and hearing signals between the inner ear and the brain. This abnormality causes vertigo and other symptoms of Ménière’s disease. Why do people get Ménière’s disease? Many theories exist about what happens to cause Ménière’s disease, but no definite answers are available. Some researchers think that Ménière’s disease is the result of constrictions in blood vessels similar to those that cause migraine headaches. Others think Ménière’s disease could be a consequence of viral infections, allergies, or autoimmune reactions. Because Ménière’s disease appears to run in families, it could also be the result of genetic variations that cause abnormalities in the volume or regulation of endolymph fluid. How does a doctor diagnose Ménière’s disease? Ménière’s disease is most often diagnosed and treated by an otolaryngologist (commonly called an ear, nose, and throat doctor, or ENT).

However, there is no definitive test or single symptom that a doctor can use to make the diagnosis. Diagnosis is based upon your medical history and the presence of: Two or more episodes of vertigo lasting at least 20 minutes each Tinnitus Temporary hearing loss A feeling of fullness in the ear Some doctors will perform a hearing test to establish the extent of hearing loss caused by Ménière’s disease. To rule out other diseases, a doctor also might request magnetic resonance imaging (MRI) or computed tomography (CT) scans of the brain. How is Ménière’s disease treated? Ménière’s disease does not have a cure yet, but your doctor might recommend some of the treatments below to help you cope with the condition. Medications. The most disabling symptom of an attack of Ménière’s disease is dizziness. Prescription drugs such as meclizine, diazepam, glycopyrrolate, and lorazepam can help relieve dizziness and shorten the attack. Salt restriction and diuretics. Limiting dietary salt and taking diuretics (water pills) help some people control dizziness by reducing the amount of fluid the body retains, which may help lower fluid volume and pressure in the inner ear.

Other dietary and behavioral changes. Some people claim that caffeine, chocolate, and alcohol make their symptoms worse and either avoid or limit them in their diet. Not smoking also may help lessen the symptoms. Cognitive therapy. Cognitive therapy is a type of talk therapy that helps people focus on how they interpret and react to life experiences. Some people find that cognitive therapy helps them cope better with the unexpected nature of attacks and reduces their anxiety about future attacks. Injections. Injecting the antibiotic gentamicin into the middle ear helps control vertigo but significantly raises the risk of hearing loss because gentamicin can damage the microscopic hair cells in the inner ear that help us hear. Some doctors inject a corticosteroid instead, which often helps reduce dizziness and has no risk of hearing loss. Pressure pulse treatment. The U.S. Food and Drug Administration (FDA) recently approved a device for Ménière’s disease that fits into the outer ear and delivers intermittent air pressure pulses to the middle ear. The air pressure pulses appear to act on endolymph fluid to prevent dizziness. Location of endolymphatic sac Credit: NIH/NIDCD Surgery. Surgery may be recommended when all other treatments have failed to relieve dizziness.

Some surgical procedures are performed on the endolymphatic sac to decompress it. Another possible surgery is to cut the vestibular nerve, although this occurs less frequently. Alternative medicine. Although scientists have studied the use of some alternative medical therapies in Ménière’s disease treatment, there is still no evidence to show the effectiveness of such therapies as acupuncture or acupressure, tai chi, or herbal supplements such as gingko biloba, niacin, or ginger root. Be sure to tell your doctor if you are using alternative therapies, since they sometimes can impact the effectiveness or safety of conventional medicines. What is the outlook for someone with Ménière’s disease? Scientists estimate that six out of 10 people either get better on their own or can control their vertigo with diet, drugs, or devices. However, a small group of people with Ménière’s disease will get relief only by undergoing surgery. What research about Ménière’s disease is being done? Insights into the biological mechanisms in the inner ear that cause Ménière’s disease will guide scientists as they develop preventive strategies and more effective treatment.

The NIDCD is supporting scientific research across the country that is: Determining the most effective dose of gentamicin with the least amount of risk for hearing loss. Developing an in-ear device that uses a programmable microfluid pump (the size of a computer chip) to precisely deliver vertigo-relieving drugs to the inner ear. Studying the relationship between endolymph volume and inner ear function to determine how much endolymph is “too much.” Researchers are hoping to develop methods for manipulating inner ear fluids and treatments that could lower endolymph volume and reduce or eliminate dizziness. Where can I find additional information about Ménière’ disease? NIDCD maintains a directory of organizations that can answer questions and provide printed or electronic information on Ménière’s. Please see the list of organizations at . Use the following keywords to help you search for organizations that can answer questions and provide printed or electronic information on Ménière’s disease: Ménière's Disease-Topic Overview Ménière's Disease Credits What is Ménière's disease? Ménière's (say "men-YEERS") disease is an inner ear problem that affects your hearing and balance. It normally occurs in only one ear at a time.

But over time, it develops in the other ear in up to half of those who have it. The disease usually occurs in people ages 40 to 60, but anyone can have it. What causes Ménière's disease? The cause of Ménière's disease is not known. But it may be related to a fluid called endolymph in the inner ear. In people with Ménière's disease, too much of this fluid builds up. This creates pressure in the parts of your inner ear that control balance. Experts aren't sure why this fluid builds up. It may be that your body produces too much of the fluid. Or maybe the fluid doesn't drain as it should from the inner ear. Or it may be both. It's hard to predict who will get Ménière's disease. But your risk may be higher than normal if you have: Another family member who has it. Had a head injury , especially if it involved your ear. Had a viral infection of the inner ear. Allergies . What are the symptoms? Ménière's disease can cause symptoms that come on quickly and last from hours to days.

During an attack, you may have: Vertigo , the feeling that you or your surroundings are spinning. This may last from minutes to hours. It may be bad enough to cause nausea and vomiting . Tinnitus , a low roaring, ringing, or hissing in your ear. Hearing loss , which may be temporary or permanent. A feeling of pressure or fullness in your ear. Most people have repeated attacks over a period of years. Attacks usually happen more often during the first few years of the disease and then come less often after that. In some cases, each attack damages the inner ear. Over time your inner ear may become so badly damaged that it no longer works as it should. Then the attacks may stop, but you may be left with: Poor balance. Roaring or hissing in the affected ear. Continued A few people with Ménière's disease have "drop attacks." A drop attack is a sudden fall while you stand or walk. It occurs without warning. It may feel like you are suddenly being pushed to the ground. People who have these attacks don't pass out, and they recover within seconds or minutes. See a doctor right away if you think you have Ménière's disease.

Prompt diagnosis and treatment may reduce both the discomfort of the attacks and your risk of hearing loss . How is Ménière's disease diagnosed? To diagnose the disease, your doctor will do a physical exam that includes checking your ears, eyes , and nervous system . The doctor will also ask questions about your past health and your symptoms, such as: How you feel when you have a vertigo attack. How long an attack usually lasts. Whether anything seems to trigger an attack, like changing your position. Whether you have other symptoms along with vertigo, like hearing loss or nausea . Your doctor may also do tests to confirm a diagnosis of Ménière's. These tests may include: A Dix-Hallpike test to find out if certain head movements trigger vertigo. Hearing tests , including one to find out if the nerve from the inner ear to the brain is working as it should. A test called an electronystagmogram (ENG), which measures your eye movements. This can help the doctor find where the problem is that's causing vertigo. Imaging tests such as an MRI or CT scan of the head. These tests can find out if the symptoms are caused by a brain problem. How is it treated?

Ménière's disease can't be cured. But your doctor can prescribe treatment to help control your symptoms and reduce how often you have attacks. Medicines Your doctor may prescribe a diuretic medicine. Diuretics help rid your body of excess fluid, so they may help prevent the buildup of fluid in your inner ear. And that may mean you have fewer attacks. Your doctor may also prescribe medicines to use when you have an attack, such as: Medicines that reduce the vertigo. These include antihistamines such as dimenhydrinate (for example, Dramamine ), sedatives such as diazepam (for example, Valium ), and the scopolamine patch ( Transderm Scop). Medicines that reduce nausea and vomiting caused by vertigo. These are called antiemetics. Continued Other treatments If symptoms are severe and don't respond to medicine, your doctor may suggest another treatment, such as surgery to reduce the fluid or pressure in the inner ear. The goal is to get rid of your symptoms while saving as much of your hearing as possible.

In rare cases of severe, lasting Ménière's disease, doctors may suggest a treatment to destroy the balance center in the inner ear (labyrinth), which can prevent vertigo. Options include: Surgery to remove the labyrinth. This is called labyrinthectomy. Chemical ablation. During this procedure, an antibiotic (usually gentamicin ) is injected into the inner ear to destroy the labyrinth. These treatments can cause permanent hearing loss, so they are usually done only as a last resort. What can you do at home for Ménière's disease? Ménière's can be hard to manage and tough to live with. But there are some things you can do that may help reduce the number of attacks you have: Eat low-salt foods. Salt makes your body hold on to excess fluid. If you eat less salt, you may have less buildup of fluid in the ear. So you may get vertigo less often. Ménière disease: MedlinePlus Medical Encyclopedia Ringing or roaring in the affected ear, called tinnitus Vertigo, or dizziness Severe vertigo is the symptom that causes the most problems. With vertigo, you feel as though you are spinning or moving, or that the world is spinning around you.

Nausea, vomiting, and sweating often occur. Symptoms get worse with sudden movement. Often, you will need to lie down. You may feel dizzy and off-balance for anywhere from 20 minutes to 24 hours. Hearing loss is often only in one ear, but it may affect both ears. Hearing tends to improve between attacks, but gets worse over time. Low frequency hearing is lost first. You also may have roaring or ringing in the ear (tinnitus), along with a sense of pressure in your ear Other symptoms include: Exams and Tests A brain and nervous system exam may show problems with hearing, balance, or eye movement. A hearing test will show the hearing loss that occurs with Ménière disease. Hearing may be near normal after an attack. A caloric stimulation test checks your eye reflexes by warming and cooling the inner ear with water. Test results that are not in the normal range can be a sign of Ménière disease. These tests may also be done to check for other causes of vertigo: Electrocochleography (ECOG) Head MRI scan Treatment There is no known cure for Ménière disease. However, lifestyle changes and some treatments can help relieve symptoms.

Your health care provider may suggest ways to reduce the amount of fluid in your body. This can often help control symptoms. Water pills (diuretics) may help relieve fluid pressure in the inner ear A low-salt diet may also help To help ease symptoms and stay safe: Avoid sudden movements, which may worsen symptoms. You may need help walking during attacks. Avoid bright lights, TV, and reading during attacks. They can make symptoms worse. Do not drive, operate heavy machinery, or climb until 1 week after your symptoms disappear. A sudden dizzy spell during these activities can be dangerous. Remain still and rest when you have symptoms. Gradually increase your activity after attacks. Symptoms of Ménière disease can cause stress. Make healthy lifestyle choices to help you cope: Eat a well-balanced, healthy diet. Don't overeat. Exercise regularly, if possible. Your provider may prescribe: Antinausea medicines to relieve nausea and vomiting Diazepam (Valium) or motion sickness medicines, such as meclizine (Antivert, Bonine, Dramamine) to relieve dizziness and vertigo You may need ear surgery if your symptoms are severe and do not respond to other treatments.

Surgery to cut the vestibular nerve helps control vertigo. It does not damage hearing. Injecting steroids or an antibiotic called gentamicin directly into the middle ear can help control vertigo. Removing part of the inner ear (labyrinthectomy) helps treat vertigo. This causes complete hearing loss. Hearing aids may be needed for severe hearing loss. Outlook (Prognosis) Ménière disease can often be controlled with treatment. Or, the condition may get better on its own. In some cases, Ménière disease can be (long-term) chronic or disabling. When to Contact a Medical Professional Call your provider if you have symptoms of Ménière disease, or if symptoms get worse. These include hearing loss, ringing in the ears, or dizziness. Prevention You can't prevent Ménière disease. Treating early symptoms right away may help prevent the condition from getting worse. Treating an ear infection and other related disorders may be helpful.

Alternative Names Hydrops; Hearing loss; Endolymphatic hydrops; Dizziness - Ménière disease; Vertigo - Ménière disease; Hearing loss - Ménière disease; Dizziness - Ménière disease Images Tympanic membrane References Chang AK, Olshaker JS. Dizziness and vertigo. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 19. Crane BT, Minor LB. Peripheral vestibular disorders. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Mosby; 2015:chap 165. Ruckenstein MJ, ed. Ménière's Disease; Evidence and Outcomes. San Diego, CA: Plural Publishing; 2010. Read More

Question: Menieres syndrome affects which part of the body?
Answer: Ears